A randomized, placebo-controlled trial of arthroscopic surgery for osteoarthritis of the knee

In July 2002, The New England Journal of Medicine reported the results of a milestone study, a randomized, placebo-controlled surgical trial of arthroscopic surgery for osteoarthritis of the knee. The results of which are exerting major influence on three paradigms: one, a practice paradigm in orthopedics; two, an important and lasting research paradigm in the evaluation of the efficacy of new surgical procedures; and three, a health care policy paradigm that potentially will have far-reaching effects. The study, only the second placebo-controlled surgical trial in the United States within the past several decades, concluded that the outcomes after arthroscopic lavage or arthroscopic debridement were no better than those after a placebo procedure, and at times better for the relief of subjective symptoms. The groundbreaking work of the study’s lead investigators, Drs. Baruch A. Brody, J. Bruce Moseley, and Nelda P. Wray, has set a new standard for the ethical evaluation of new surgical procedures before their dissemination. The study led to the issuance of advisories by both the Department of Veterans Affairs and the U.S. Medicare program regarding the use of arthroscopic surgery for treating osteoarthritis of the knee, and the policy impact of these advisories is rather profound and speaks highly of the study, its scientific rigor, and especially the work of these esteemed health services researchers.